以癫痫为首发症状的颅内海绵状血管瘤显微外科治疗（附30例临床分析）

目的对显微外科手术治疗30例以癫痫为首发症状的海绵状血管瘤的手术治疗效果进行回顾性分析,探讨以癫痫为首发症状的海绵状血管瘤的治疗策略。方法手术治疗30例以癫痫为首发症状的海绵状血管瘤。全身强直阵挛性发作24例,失神发作1例,复杂部分性发作1例,简单部分性发作2例,癫痫持续状态2例。结果采用Engle效果分级。Engle效果分级：21例行海绵状血管瘤切除术,EngleⅠ达到95.23%;EngleⅡ为4.67%。术中病灶＋含铁血黄素清除术9例,EngleⅠ达到77.78%;EngleⅡ为22.22%。术前用药物控制借鉴Engle效果分级Ⅲ和Ⅳ者18例,术后达到EngleⅠ15例,占83.33%;EngleⅡ3例占16.67%;术中、术后无严重并发症及死亡病例。结论对伴癫痫为首发症状的海绵状血管瘤,积极的显微外科手术治疗可获得满意的治疗效果。

Microsurgical treatment of intracerebral cavernous angioma with epilepsy as first symptom in 30 cases

Objective To analyze the microsurgical treatment strategy of 26 cases with epilepsy as first symptom of intracerebral cavernous angioma.Methods The clinical data of 26 patients with epilepsy as first symptom of intracerebral cavernous angioma,who underwent surgery in our hospital from January,2009 to December,2013,were analyzed retrospectively.In all the cases,24 cases were generalized tonic-clonic seizures,one case were absence seizures,one case were complex partial seizures,two cases of status epilepticus.To evaluate the effect of operations by the Engle scale of epilepsy.Results According to Engle standard of the curative effect,grade Ⅰ accouted for 95.23%,grade Ⅱ 4.67%,respectively at lesionectony itself removed in 21 cases.GradeⅠaccouted for 77.78%,grade Ⅱ 22.22%,respectively at lesionectony itself and hemosiderin resection in 9 cases.Effect of preoperative use drug control reference Engle grading of grade Ⅲ and Ⅳ in 18 cases.Postoperative to Engle grade Ⅰ accouted for 83.33% and Engle grade Ⅱ accounted for 16.67%.No death and severe complication occurred in 30 patients.Conclusion The microsurgical treatment is a safe and efficient way to treat intracerebral cavernous angioma with epilepsy as first symptom.